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Clinical Comparison of Full-Endoscopic and Microscopic Unilateral Laminotomy for Bilateral Decompression in the Treatment of Elderly Lumbar Spinal stenosis: A Retrospective Study with 12-Month Follow-Up

Authors Yang F, Chen R, Gu D, Ye Q, Liu W, Qi J, Xu K, Fan X

Received 23 March 2020

Accepted for publication 22 May 2020

Published 11 June 2020 Volume 2020:13 Pages 1377—1384


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa

Fei Yang,* Rigao Chen,* Dangwei Gu, Qingqing Ye, Wei Liu, Jianhua Qi, Kai Xu, Xiaohong Fan

Department of Spine Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiaohong Fan Email

Purpose: Although lumbar spinal stenosis (LSS) is the most common spinal disease in the elderly, there is still a confusion about the appropriate surgical treatment strategy. The aim of this study was to compare the safety and efficacy of full-endoscopic and microscopic unilateral laminotomy for bilateral decompression (ULBD) for LSS in elderly patients.
Patients and Methods: A retrospective analysis of 61 consecutive elderly patients with LSS who underwent either full-endoscopic (FE group) or microscopic (Micro group) unilateral laminotomy for bilateral decompression was performed. Clinical data were assessed before 2 weeks, 3 months, 6 months and 12 months after surgery using the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI) and the modified MacNab criteria.
Results: There are no significant differences in VAS (back and leg) and ODI between the two groups. However, the VAS back pain in the FE group was significantly improved compared to the Micro group at 2 weeks. The rate of excellent or good outcomes was 87.88% and 85.71% in the FE and Micro group, respectively (P> 0.05). The hospital stay and early ambulation in FE group were shorter than those in Micro group, but the operation time was longer (P< 0.05). The complications between the FE group (18.18%) and the Micro group (17.86%) were minor (P> 0.05).
Conclusion: Both full-endoscopic and microscopic decompression have achieved favorable clinical results in treating elderly lumbar spinal stenosis, and the complications are minor. Full-endoscopic decompression has the advantages of small incision and rapid recovery, which can be used as an alternative for the treatment of lumbar spinal stenosis, especially the elderly with comorbidities.

Keywords: central stenosis, minimally invasive spinal surgery, MISS, comorbidity, complication

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